Centimeter ruler (flexible, clear)
EXAMINATION
TECHNIQUE | FINDINGS |
---|---|
Pigmented nevi. Nonpigmented striae. Freckles. Birthmarks. | |
UNEXPECTED:Dysplastic, precancerous, or cancerous nevi. Chloasma. Unpigmented skin. Generalized or localized color changes. Vascular skin lesions. Vascular changes. | |
![]() | EXPECTED:Thickness variations, with eyelids thinnest, areas of rubbing thickest. Calluses on hands and feet. |
UNEXPECTED:Atrophy. Hyperkeratosis. Corns. | |
![]() | EXPECTED:Bilateral symmetry. |
![]() | EXPECTED:Clean. |
Palpate skin | |
![]() | EXPECTED:Minimal perspiration or oiliness. Increased perspiration (associated with activity, environment, obesity, anxiety, excitement) noticeable on palms, scalp, forehead, axillae. |
UNEXPECTED:Damp intertriginous areas. | |
EXPECTED:Cool to warm. Bilateral symmetry. | |
![]() | EXPECTED:Smooth, soft, and even. Roughness resulting from heavy clothing, cold weather, or soap. |
UNEXPECTED:Extensive or widespread roughness. | |
![]() | EXPECTED:Resilience. |
Gently pinch skin on forearm or in sternal area, and release. | UNEXPECTED:Failure of skin to return to place quickly. |
![]() | |
Inspect and palpate lesions | |
UNEXPECTED:See table on pp. 36–39 |
Description | Examples |
---|---|
Macule | |
Flat, circumscribed area that is a change in skin color; less than 1 cm in diameter | Freckles, flat moles (nevi), petechiae, measles, scarlet fever |
Papule | |
Elevated, firm, circumscribed area less than 1 cm in diameter | Wart (verruca), elevated moles, lichen planus |
Patch | |
Flat, nonpalpable, irregular-shaped macule more than 1 cm in diameter | Vitiligo, port-wine stains, mongolian spots, café au lait spots |
Plaque | |
Elevated, firm, and rough lesion with flat top surface greater than 1 cm in diameter | Psoriasis, seborrheic and actinic keratoses |
Wheal | |
Elevated irregular-shaped area of cutaneous edema; solid, transient; variable diameter | Insect bites, urticaria, allergic reaction |
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